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To Purchase Super Series Team
Insurance
Your Team Must First Have a
Valid (Current) 2012 Registration and Roster.
Your registered Super Series Roster
specifies WHO is insured.
If your team does not have
a current Super Series team registration (and roster), coverage will not be
provided, nor will claims be honored. You will be
required to provide your valid (current season) team ID prior to purchasing
insurance.
Only the
manager, players and coaches
listed on your valid Super Series team roster are covered by your insurance - and it is important
that you keep your roster up to date through our
Roster Control Center if you have
roster changes.
Our
plan offers $1,000,000 in liability coverage with a $3,000,000
aggregate per event with no deductible. This policy
protects your coaches and volunteers. The
coverage is provided for third party lawsuits of negligence
brought against your team during practice, play or tournaments
for Bodily Injury and Property Damage. The plan will pay
sums for which the insured becomes legally obligated to pay as
damages because of:
Bodily
Injury and Property Damage
Participant
Legal Liability
Premises
and Operations
Personal
and Advertising Injury
Defense and Legal
Fees are covered in addition to the policy limits provided.
Property owners can be provided certificates of insurance
naming them as additionally insured, upon request, at no
additional charge. However, should they require their
name on an endorsement, a separate fee will apply.
General Liability is provided by:
TUDOR Insurance, a member of the
Western World Insurance Group
EXCESS ACCIDENT COVERAGE:
$100,000.00 Maximum Medical Benefit per Claim
$10,000.00 Accidental
Death/Dismemberment Benefit
per Claim
$100.00 Deductible per
Claim
This policy covers all registered players, and
registered coaches, against specific losses resulting directly and
independently of all other causes, from accidental bodily
injury sustained while participating as a member in a
scheduled game, official tournament, or practice session, or
while traveling directly to or from such game or practice
session.
Accidental
Medical Expense Benefit pays for reasonable medical* expenses
incurred as the result of injuries sustained in a covered
accident up to the policy limits and subject to the
deductible. The policy covers necessary medical or
surgical treatment, and services or supplies which are
prescribed by the person's attending physician. The
first expense must be incurred within 26 weeks of the accident
and the last expense within two years of the accident.
Excess coverage is provided over and above
other group blanket or franchise health insurance
coverage; other group hospital or medical services plans
& pre-payment coverage; any coverage under labor
management trustee or employee benefit organization plans;
coverage under an governmental program; coverage required or
provided by any statute & automobile reparations insurance
(no fault) coverage. Please note any amounts paid
by another plan as defined above (or applicable state
variation) cannot be used to satisfy any deductible under our
policy.
Accidental
Death and Dismemberment benefit pays $10,000 for an injury
resulting from a covered accident resulting in loss of life;
both hands or both feet; or sight of both eyes; one hand
and one foot; or hand or foot and sight of one eye. Plan
pays $5,000 for the loss of one hand; one foot; or the sight
of one eye. Loss must occur within 180 days of the
accident. If more than one loss is sustained, only one
of the amounts, (the largest), will be payable. Loss of
hand or foot means severance through, or above wrist and ankle
joint. Loss of eye means entire and irrecoverable loss
of sight.
The
provisions of the policies constitute the only
agreement between the insured and the Insurance
Companies.
*
"Reasonable medical expenses" means the amount of
such expenses
which are not in excess of the average charges made
for medical or surgical treatment, services or supplies
in the locality where it is received.
The
excess accident coverage is provided by:
The Hartford Ins. Co. of Alpharetta, Ga.
This information
is only for general information and none of the above shall
alter or amend the wording of the actual policy. The
wording of the policy constitutes the agreement between the
insured and the insurance company.
This coverage protects your team wherever you play,
or practice (as a team), including within other
organizational events.
2012 Team Rates:
Coverage
Period:
If
purchased PRIOR to Jan. 5, 2012,
coverage commences on January 5, 2012 and extends thru
January 4, 2013.
If
purchased AFTER January 5, 2012,
coverage commences on the date of purchase and extends thru
January 4, 2013.
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Team Ages: 6U thru 12U |
$91.00 |
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Team Ages: 13U thru 15U |
$118.00 |
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Team Ages: 16U thru 18U |
$150.00 |
$100.00
Deductible
No Refunds After Purchase
Insurance, once issued, cannot be cancelled
since the
provider is legally bound to provide
the coverage
as
detailed in the issued
team certificate.
1) You
Must Have a Valid
Super Series Team Registration to Purchase This Insurance.
2) Then
Click on Purchase Button Below
3)
If, after purchase, a team changes its team name, or manager,
this is regarded as a new team, and requires a new insurance
purchase.
 or
COMPLETE
YOUR APPLICATION
and PURCHASE INSURANCE ONLINE!
With Your Visa or Mastercard
Credit Card
Must
include cardholders' name, number and expiration date
Debit cards are
NOT accepted.
Team
Managers are legally required by the insurance provider to have all parents sign an insurance waiver
form. All managers are recommended to then retain all of the signed
waiver forms in your team records for a minimum of five
years.
CLICK HERE FOR PRINTABLE
WAIVER FORM
This coverage expires
at
12:00 A.M.
on January 5, 2013
No Refunds - No Cancellation
Insurance, once issued, cannot be cancelled
since the
provider is legally bound to provide
the coverage
as
detailed in the issued
team certificate.
For
More General Insurance Information
or additional
copies of your team
insurance certificate please contact:
Bene-Marc
Insurance
(800) 247-1734
CLAIMS and CLAIM
FORMS:
To obtain a
claim form, or to file a claim,
please contact our insurance administrator:
Bene-Marc Insurance
800-247-1734
E-Mail:
ksevlija@bene-marc.com
Our
Insurance Program is Administered by:
Bene-Marc,
Inc.
6301 Southwest Blvd, Suite
101
Fort Worth, Texas 76132-1063
800-247-1734 or 817-738-6899
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